Vascular depression

Research until today has found a positive relationship between vascular risk factors and depression. With the advance in neuroimaging methods in the last years, a more definite relation between cerebrovascular diseases and old-age depression have been described, and in the light of the studies in this field, a 'vascular depression' subtype has been defined. According to this hypothesis, 'vascular depression' implies a special depression subtype which begins first time in old age, which is accompanied less by depressive mood, characterized by impairment in cognitive abilities, especially in executive functions, dominated by psychomotor retardation and somatic symptoms, and lack of family history of depression. A group of researchers stated that defining vascular depression only with clinical findings would be insufficient, suggested brain imaging findings are required for the diagnosis, and subcortical hyperintensities are related to depression symptoms. Late-onset depression is shown to be related to frontal subcortical white-matter hyperintensities, and these findings were found to be correlated with affect dysregulation and executive dysfunction in late-life depression. Executive dysfunction as well as memory and attention problems in late-onset depression have been shown in different studies. Thus, vascular depression hypothesis is thought to be related with subcortical dementia upon these findings. There is currently no consensus on the concept of vascular depression and diagnostic criteria. But this concept which is explaining a subgroup of late-life depressions, predicting the treatment outcome, and implying a preventable disease with the control of vascular factors, makes vascular depression a very important topic. In this review, research on vascular depression hypothesis, findings and critics about the concept will be reviewed.